Cardiac Exam set 1
A nurse is assisting with with checking blood pressures at a local health care fair. To which client would the nurse pay particular attention?
A 40-year-old African-American man Explanation: Prevalence of hypertension varies by ethnicity, with African Americans having the highest prevalence.
A 56-year-old male client at a screening event has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, the client states, "My pressure has never been this high. Do you think my doctor will prescribe medication to reduce it?" What is the nurse's best response?
"A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure reassessed several times before a diagnosis can be made." Explanation: Hypertension is confirmed by two or more readings with systolic pressure of at least 140 mm Hg and diastolic pressure of at least 90 mm Hg. An age of 56 does not constitute a risk factor in and of itself. The nurse should not tell the student that there is no need to worry.
A client diagnosed with hypertension begins drug therapy using an antihypertensive agent. The nurse instructs the client's spouse to remove any objects in the home that can lead to falls. Which client statement confirms that the teaching has been successful?
"Antihypertensive drugs can lead to falls." Explanation: One of the side effects of all antihypertensive drugs is hypotension, which can lead to falls.
A 55-year-old client comes to the clinic for a routine check-up. The client's BP is 159/100 mm Hg and the physician diagnoses hypertension after referring to previous readings. The client asks why it is important to treat hypertension, since the client denies any discomfort. What would be the nurse's best response?
"Hypertension greatly increases your risk of stroke and heart disease." Explanation: Hypertension, particularly elevated systolic BP, increases the risk of death, stroke, and heart failure in people older than 50 years. Hypertension is not a direct precursor to pulmonary emboli, and it does not put older adults at increased risk of type 1 diabetes or cancer. It is not the leading cause of death in people 55 years of age.
A nurse working in the clinic is seeing a client who has just been prescribed a new medication for hypertension. The client asks why hypertension is sometimes called the "silent killer." What is the best response by the nurse?
"Hypertension often causes no symptoms." Explanation: Hypertension is sometimes called the "silent killer" because people with it are often symptom free. Physical examination may reveal no abnormalities other than elevated blood pressure. People with hypertension may remain asymptomatic for many years. The usual consequences of prolonged, uncontrolled hypertension are myocardial infarction, heart failure, renal failure, strokes, and impaired vision. Pain is not usually an issue, but that is not why hypertension is called the "silent killer." Hypertension is easily diagnosed by taking a series of blood pressure readings.
The nurse is caring for a client newly diagnosed with hypertension. Which statement by the client indicates the need for further teaching?
"If I take my blood pressure and it is normal, I don't have to take my blood pressure pills." Explanation: The client needs to understand the disease process and how lifestyle changes and medications can control hypertension. The client must take all medications as directed. A normal blood pressure indicates the medication is producing the desired effect. The other responses do not indicate the need for further teaching.
The public health nurse is presenting a workshop on hypertension for the Parent Teacher Organization of the local elementary school. A parent asks the nurse who is at risk for hypertension. What would be the nurse's best answer?
"People at highest risk for hypertension include those with diabetes." Explanation: Screening of BP is an important method for identifying people at risk for heart failure, renal failure, and stroke. Those at highest risk are older adults, African Americans, and clients with diabetes mellitus. Therefore options A, C, and D are incorrect.
A nurse is teaching a client with newly diagnosed hypertension who asks if there is any harm in stopping antihypertensive medication. What is the nurse's best response?
"Rebound hypertension can occur." Explanation: Clients need to be informed that rebound hypertension can occur if they stop antihypertensive medications suddenly. This can be extremely dangerous and have serious consequences. Hypotension would not be a problem with discontinuation of antihyperstensive medications.
A client with newly diagnosed hypertension has come to the clinic for a follow-up visit. The client asks the nurse why she has to come in so often. What would be the nurse's best response?
"We do this to make sure your health is stable. We'll then monitor it at routinely scheduled intervals." Explanation: When hypertension is initially detected, nursing assessment involves carefully monitoring the BP at frequent intervals and then at routinely scheduled intervals. The reference to stroke is frightening and does not capture the overall rationale for the monitoring regimen. Changes throughout the day are not a clinical priority for most clients. The client must not change medication doses unilaterally.
Officially, hypertension is diagnosed when the client demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period.
140, 90 Explanation: According to the categories of blood pressure levels established by the JNC VI, stage 1 hypertension is demonstrated by a systolic pressure of 140 to 159, or a diastolic pressure of 90 to 99. Pressure of 130 systolic and 80 diastolic falls within the prehypertension classification range for an adult. Pressures of 110 systolic and 60 diastolic, and of 120 systolic and 70 diastolic, fall within the normal range for an adult.
Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension?
A client diagnosed with kidney disease Explanation: Secondary hypertension is an elevated blood pressure that results from or is secondary to some other disorder such as kidney disease, a tumor of the adrenal medulla, or atherosclerosis. Depression alone is typically not associated with hypertension. Advanced age and alcohol intake are considered factors for essential hypertension.
A nurse is performing blood pressure screenings at a local health fair. While obtaining subjective assessment data from a client with hypertension, the nurse learns that the client has a family history of hypertension and she herself has high cholesterol and lipid levels. The client says she smokes one pack of cigarettes daily and drinks "about a pack of beer" every day. The nurse notes what nonmodifiable risk factor for hypertension?
A family history of hypertension Explanation: Unlike cholesterol levels, alcohol intake, and adherence to treatment, family history is not modifiable.
A community health nurse is screening for hypertension. Which client would the nurse focus on most intensively?
A middle-aged African-American man Explanation: African Americans have the highest prevalence of hypertension. The other choices all have a lower incidence of hypertension, so the nurse should pay greatest attention to the middle-aged African-American man.
An older adult client visits the clinic for a blood pressure (BP) check. The client's hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about the blood pressure medicine?
A possible adverse effect of blood pressure medicine is dizziness when you stand. Explanation: A possible adverse effect of all antihypertensive drugs is postural hypotension, which can lead to falls. Teaching should include tips for managing syncope and dizziness. The nurse would not teach the client to take the medicine on an empty stomach.
An older adult client visits the clinic for a blood pressure check. The client's hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about blood pressure medicine?
A possible adverse effect of blood pressure medicine is dizziness when you stand. Explanation: A possible adverse effect of all antihypertensive drugs is postural hypotension, which can lead to falls. Teaching should include tips for managing syncope and dizziness. The nurse would not teach the client to take the medicine on an empty stomach.
Which ethnic background would the nurse screen for hypertension at an early age?
African population Explanation: The population of African descent is at the highest risk for development of hypertension. The other ethnic backgrounds have a lower risk.
A community health nurse is planning an educational campaign addressing hypertension. The nurse should anticipate that the incidence and prevalence of hypertension are likely to be highest among members of what ethnic group?
African-Americans Explanation: The prevalence of hypertension varies by ethnicity and gender, and is estimated at approximately 32.9% among Caucasian men, 30.1% among Caucasian women, 44.9% among black men, 46.1% among black women, 29.6% among Hispanic men, and 29.9% among Hispanic women. The prevalence of hypertension among blacks is among the highest in the world.
A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client?
Age Explanation: Age and family history for cardiovascular disease are risk factors that cannot be changed. Obesity, inactivity, and disylipidemia are risk factors that can be improved by the client through dietary changes, exercise, and other healthy lifestyle choices.
Hypertension is defined as "sustained elevations in systolic or diastolic blood pressures that exceed prehypertension levels." What are some of the consequences of hypertension that make it such a health menace in the United States?
All options are correct. Explanation: Healthcare professionals have revised guidelines for identifying hypertension because hypertension places people at risk for heart disease, heart failure, stroke, and kidney disease.
An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed the client hydrochlorothiazide and enalapril. What will the nurse be sure to include in educating this client?
Change positions (lying or sitting to standing) slowly. Explanation: Antihypertensive medications can cause hypotension, especially postural hypotension that may result in injury. The nurse teaches clients to change positions slowly when moving from a lying or sitting position to a standing position. Rebound hypertension occurs when antihypertensive medications are stopped abruptly. The nurse also counsels elderly clients to use supportive devices such as handrails and walkers to prevent falls that could result from dizziness. Eating salty foods could defeat the purpose of taking the antihypertensive medications.
The nurse is caring for an elderly client with a diagnosis of hypertension, who is taking several antihypertensive medications. Which safety precaution is the nurse most likely to reinforce?
Changing positions slowly related to possible hypotension Explanation: The elderly have impaired cardiovascular reflexes and thus are more sensitive to the extracellular volume depletion caused by diuretics and to the sympathetic inhibition caused by adrenergic antagonists. The nurse teaches clients to change positions slowly when moving from a lying or sitting position to a standing position. This will help prevent falls. Eating extra potassium is not a good idea if taking a potassium-sparing diuretic. The other choices are good teaching points, but not necessarily safety precautions
A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply.
Coronary artery disease Myocardial infarction Stroke Explanation: People with hypertension may remain asymptomatic for many years. When specific signs and symptoms appear, however, they usually indicate vascular damage. Coronary artery disease with angina and myocardial infarction are common consequences of hypertension. Cerebrovascular involvement may lead to a stroke. Tension pneumothorax and pancreatitis are not directly related to hypertension.
A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore blood pressure below hypertensive levels?
Decrease sodium intake Explanation: The nurse should instruct clients with prehypertension to avoid or decrease sodium and iodine intake. Increasing fluid intake raises circulating blood volume and systemic vascular resistance. Over-the-counter decongestants decrease pulmonary congestion and not hypertension.
A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore his blood pressure below hypertensive levels?
Decrease sodium intake. Explanation: The nurse should instruct clients with prehypertension to avoid or decrease sodium and iodine intake. Increasing fluid intake raises circulating blood volume and systemic vascular resistance. Over-the-counter decongestants decrease pulmonary congestion and not hypertension.
A patient has been diagnosed with prehypertension and has been encouraged to exercise regularly and begin a weight loss program. What other healthcare professional may be helpful for the client to see?
Dietician Explanation: Clients with prehypertension and a need to lose weight will benefit from a dietician for food selections and menu planning. An occupational therapist works with clients for meaning activites for daily tasks. The pharmacist deals with medications and the social worker will help with dealing with problems to improve life.
A nurse educator is providing information about hypertension to a small group of clients. A participant asks "What can I do to decrease my blood pressure and thus my risk for heart problems?" The nurse describes modifiable and nonmodifiable risk factors. Which of the following risk factors can the client modify?
Dyslipidemia Explanation: Modifiable risk factors for cardiovascular problems in clients with hypertension include smoking, dyslipidemia, diabetes mellitus, impaired renal function, obesity, and physical inactivity.
A client with newly diagnosed hypertension asks how to decrease the risk for related cardiovascular problems. What risk factor is modifiable by the client?
Dyslipidemia Explanation: Age, family history, and impaired renal function are risk factors for cardiovascular disease related to hypertension that the client cannot change. Obesity, inactivity, and disylipidemia are risk factors that the client can improve through diet, exercise, and other healthy lifestyle changes.
A patient with long-standing hypertension is admitted to the hospital with hypertensive urgency. The physician orders a chest x-ray, which reveals an enlarged heart. What diagnostic test does the nurse anticipate preparing the patient for to determine left ventricular enlargement?
Echocardiography Explanation: Left ventricular hypertrophy can be assessed by echocardiography, but not by any of the other measures listed.
A nurse is teaching about lifestyle modifications to a group of clients with known hypertension. Which statement would the nurse include in the education session?
Engage in aerobic activity at least 30 minutes/day most days of the week. Explanation: Recommmended lifestye modifications to prevent and manage hypertension include maintaining a normal body mass index (about 24; greater than 25 is considered overweight), maintaining a waist circumference of less than 40 inches for men and 35 inches for women, limiting alcohol intake to no more than 2 drinks for men and 1 drink for women per day, and engaging in aerobic activity at least 30 minutes per day most days of the week.
A client has been diagnosed as being prehypertensive. What should the nurse encourage this client to do to aid in preventing a progression to a hypertensive state?
Exercise on a regular basis. Explanation: To prevent or delay progression to hypertension and reduce risk, JNC 7 urged health care providers to encourage people with blood pressures in the prehypertension category to begin lifestyle modifications, such as nutritional changes and exercise. There is no need for clients to limit their activity in the morning or to avoid potassium and protein intake.
When teaching a client about hypertension and lifestyle changes what does the nurse emphasizes should be included in the diet?
Fresh fruits and vegetables Explanation: The dietary approach to stop hypertension states that a diet high in fruits and vegetables and low in fat and sodium will prevent or control hypertension. There is no need to consume chloride-containing foods. Whole mile milk and cheeses are high in saturated fats and should be avoided. While alcohol is considered acceptable in low quantities, it is not something that must be included in the diet.
A client, newly prescribed a low-sodium diet due to hypertension, is asking for help with meal choices. The client provides four meal choices, which are favorites. Which selection would be best?
Green pepper stuffed with diced tomatoes and chicken Explanation: Fresh vegetables are low in sodium with diced tomatoes (fresh) and chicken is a good low-sodium, high vegetable and protein selection. Cheese and soup (tomato and creamed) are high in sodium. Processed meats such as a hot dog and condiments such as ketchup are high in sodium.
What response is appropriate when a client with hypertension declines to take prescribed antihypertensive medications because due to the absence of symptoms?
Inform the client that this is why hypertension is known as "the silent killer." Explanation: Hypertension is known as "the silent killer" because many people never experience any troubling symptoms until they are in an extremely dangerous medical position. Sometimes the condition actually leads to death without any warning. That is why it is important to take medications as prescribed in addition to following the recommended diet.
A client experiences orthostatic hypotension while receiving furosemide to treat hypertension. How will the nurse intervene?
Instruct the client to sit for several minutes before standing. Explanation: To minimize the effects of orthostatic hypotension, the nurse should instruct the client to rise slowly, such as by sitting for several minutes before standing. Administering I.V. fluids would be inappropriate (unless the client were dehydrated) because doing so would counteract the effects of furosemide and could cause fluid imbalance. Administering a vasodilator, isosorbide, would further reduce the client's blood pressure, worsening orthostatic hypotension. Inserting an indwelling urinary catheter would make it easier to monitor urine output, but wouldn't minimize the effects of orthostatic hypotension.
A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize?
It takes 2 to 3 months for the taste buds to adapt to decreased salt intake. Explanation: It takes 2 to 3 months for the taste buds to adapt to changes in salt intake. Knowing this may help the client adjust to reduced salt intake. The client should be advised to limit alcohol intake.
The nurse is screening a number of adults for hypertension. What range of blood pressure is considered normal?
Less than 120/80 mm Hg Explanation: JNC 7 defines a blood pressure of less than 120/80 mm Hg as normal, 120 to 129/80 to 89 mm Hg as prehypertension, and 140/90 mm Hg or higher as hypertension.
The nurse is developing a teaching plan for a client diagnosed with hypertension. What would be important for the nurse to emphasize as part of the plan of care?
Limiting sodium intake in the diet Explanation: Research findings indicate that smoking cessation, weight loss, reduced alcohol and sodium intake, and regular physical activity are effective lifestyle adaptations to reduce blood pressure. Limiting one's daily alcohol to 24 ounces of beer for men is recommended. Table salt should be limited to 1 teaspoon daily.
A client hospitalized for treatment of hypertension is being prepared for discharge. Which teaching topic should the nurse should be sure to cover?
Maintaining a low-sodium diet Explanation: The nurse must teach the hypertensive client how to modify his diet to restrict sodium and saturated fats. In addition to teaching about adverse effects of ordered antihypertensives, she must discuss the actions and dosages of these drugs. A client receiving antihypertensives may also take a diuretic as part of the drug regimen and thus may require dietary potassium supplements and high-potassium foods to avoid electrolyte disturbances. Instead of skipping medication if dizziness occurs, the client should notify the physician of this symptom. The client receiving antihypertensives at home takes them by mouth, not I.V.
A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse?
Numbness and weakness in the left arm Explanation: Hypertensive emergencies are acute, life-threatening BP elevations that require prompt treatment in an intensive care setting because of the serious target organ damage that may occur. The finding of numbness and weakness in left arm may indicate the client is experiencing neurological symptoms associated with an ischemic stroke because of the severely elevated BP; immediate intervention is required. Urine output of 40 mL/h is within normal limits. The other findings are likely caused by the hypertension and require intervention, but they do not require action as urgently as the neurologic changes.
A nurse is teaching an adult female client about the risk factors for hypertension. What should the nurse explain as risk factors for primary hypertension?
Obesity and high intake of sodium and saturated fat Explanation: Obesity, stress, high intake of sodium or saturated fat, and family history are all risk factors for primary hypertension. Diabetes and oral contraceptives are risk factors for secondary hypertension. Metabolic syndrome, renal disease, and coarctation of the aorta are causes of secondary hypertension.
A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together?
Potassium level Explanation: Amiloride (Midamor) is a potassium-sparing diuretic, meaning that it causes potassium retention. The nurse should monitor for hyperkalemia (elevated potassium level) if given with an ACE inhibitor, such as lisinopril (Zestril) or angiotensin receptor blocker.
Which term is refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued?
Rebound Explanation: Rebound hypertension may precipitate a hypertensive crisis. Essential or primary hypertension denotes high blood pressure from an unidentified source. Secondary hypertension denotes high blood pressure from an identified cause, such as renal disease.
A patient is flying overseas for 1 week for business and packed antihypertensive medications in a suitcase. After arriving at the intended destination, the patient found that the luggage had been stolen. If the patient cannot take the medication, what condition becomes a concern?
Rebound hypertension Explanation: Patients need to be informed that rebound hypertension can occur if antihypertensive medications are suddenly stopped. Thus, patients should be advised to have an adequate supply of medication, particularly when traveling and in case of emergencies such as natural disasters. If traveling by airplane, patients should pack the medication in their carry-on luggage.
When caring for a client with essential hypertension what instruction should the nurse provide to the client to normalise blood pressure?
Reduce sodium intake. Explanation: The nurse advises the client with essential hypertension to reduce sodium intake. The nurse also advises the client to reduce oral fluid to decrease circulating blood volume and systemic vascular resistance and adhere to a low-fat diet.
The nurse is collaborating with the dietitian and a client with hypertension to plan dietary modifications. What modifications should be made?
Reduced intake of fat and sodium Explanation: Lifestyle modifications usually include restricting sodium and fat intake, increasing intake of fruits and vegetables, and implementing regular physical activity. There is no need to increase calcium, potassium, and vitamin intake. Calorie restriction may be required for some clients, but a specific reduction in protein and carbohydrates is not normally indicated.
The nurse is caring for a client newly diagnosed with secondary hypertension. Which condition contributes to the development of secondary hypertension?
Renal disease Explanation: Secondary hypertension occurs when a cause for the high blood pressure can be identified. These causes include renal parenchymal disease, narrowing of the renal arteries, hyperaldosteronism (mineralocorticoid hypertension), pheochromocytoma, certain medications (e.g., prednisone, epoietin alfa), and coarctation of the aorta. High blood pressure can also occur with pregnancy; women who experience high blood pressure during pregnancy are at increased risk of ischemic heart disease, heart attack, stroke, kidney disease, diabetes, and death from heart attack. Calcium deficiency or acid-based imbalance does not contribute to hypertension.
Which of the following is the nurse most correct to recognize as a direct effect of client hypertension?
Renal dysfunction resulting from atherosclerosis Explanation: The nurse is most correct to realize high blood pressure damages the arterial vascular system and accelerates atherosclerosis. The effect of the atherosclerosis impairs circulation to the kidney, resulting in renal failure. Neither anemia, hyperglycemia, nor emphysema occurs as a direct effect of hypertension.
A client with primary hypertension reports dizziness with ambulation when taking the prescribed alpha-adrenergic blocker. When teaching this client, what should the nurse emphasize?
Rising slowly from a lying or sitting position Explanation: Clients who experience postural hypotension should be taught to rise slowly from a lying or sitting position and use a cane or walker if necessary for safety. It is not necessary to teach these clients about increasing fluids or taking medication in the morning (this would increase the effects of dizziness). Clients should not be taught to stop the medication if dizziness persists because this is unsafe and beyond the nurse's scope of practice.
A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension?
Secondary Explanation: Secondary hypertension is elevated BP that results from or is secondary to some other disorder. This type of hypertension is not primary, essential, or malignant.
Which term describes high blood pressure from an identified cause, such as renal disease?
Secondary hypertension Explanation: Secondary hypertension is high blood pressure from an identified cause, such as renal disease. Primary hypertension denotes high blood pressure form an unidentified source. Rebound hypertension is pressure that is controlled with therapy and becomes uncontrolled (abnormally high) when that therapy is discontinued. A hypertensive emergency is a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage.
A client comes to the walk-in clinic complaining of frequent headaches. While assessing the client's vital signs, the nurse notes the BP is 161/101 mm Hg. According to JNC 7, how would this client's BP be defined if a similar reading were obtained at a subsequent office visit?
Stage 2 hypertensive Explanation: JNC 7 defines stage 2 hypertension as a reading ≥ 160/100 mm Hg.
The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is help?
Stress reduction to lower prehypertensive state Explanation: A blood pressure of 124/84 mm Hg is now considered to be in the lower range of prehypertension. Knowledge of stress reduction may be helpful in lowering the blood pressure without medication therapy. A blood pressure of 124/84 mm Hg is not considered a low blood pressure or in need of medication therapy due to hypertension. Diagnostic testing for cardiac functioning is not typical for a client with prehypertension.
During the physical assessment of a client with hypertension, what would the nurse expect to be the most obvious finding?
Sustained increase of either one or both systolic or diastolic measurements. Explanation: The most obvious finding during a physical assessment is a sustained elevation of one or both blood pressure measurements. A client being overweight might depict having hypertension. An anemic client does not display any traits of having hypertension.
The nurse is administering medications on a medical-surgical unit. A client is ordered to receive 40 mg oral nadolol for the treatment of hypertension. Before administering the medication, the nurse should
check the client's heart rate. Explanation: Nadolol is a beta-blocker. A desired effect of this medication is to reduce the pulse rate in clients with tachycardia and elevated blood pressure (BP). The nurse should check the client's heart rate (HR) before administering nadolol to ensure that the pulse is not less than 60 beats per minute. The other interventions are not indicated before administering a beta-blocker medication.
The nurse is teaching a client about hypertension and the effects on the left ventricle. What diagnostic test will the nurse describe?
echocardiography Explanation: Echocardiography will reveal an enlarged left ventricle. Fluorescein angiography reveals leaking retinal blood vessels, and a PET scan is used to reveal abnormalities in blood pressure. A CT scan reveals structural abnormalities.
A blood pressure (BP) of 140/90 mm Hg is considered to be
hypertension. Explanation: A BP of 140/90 mm Hg or higher is hypertension. A blood pressure less than 120/80 mm Hg is considered normal. A BP of 120 to 139/80 to 89 mm Hg is prehypertension. Hypertensive emergency is a situation in which BP is severely elevated and there is evidence of actual or probable target organ damage.
The nurse understands that client education related to antihypertensive medication should include which of the following?
inform client to avoid over-the-counter cold and sinus medications Explanation: Doubling doses could cause serious hypotension (HTN) and is not recommended. Medications should be taken as prescribed. Many over-the-counter preparations can precipitate HTN. Stopping antihypertensives abruptly can precipitate a severe hypertensive reaction and is not recommended. Patients with hypertension must make considerable effort to adhere recommended lifestyle modifications.
A client who was recently diagnosed with prehypertension is to meet with a dietitian and return for a follow-up with the cardiologist in 6 months. What would this client's treatment likely include?
nonpharmacological interventions Explanation: Nonpharmacologic interventions are used for clients with prehypertension.
Hypertension that can be attributed to an underlying cause is termed
secondary hypertension. Explanation: Secondary hypertension may be caused by a tumor of the adrenal gland (e.g., pheochromocytoma). Primary, or essential, hypertension has no known underlying cause. Isolated systolic hypertension is demonstrated by readings in which the systolic pressure exceeds 140 mm Hg and the diastolic measurement is normal or near normal (less than 90 mm Hg).
According to the classification of hypertension diagnosed in older adults, hypertension that can be attributed to an underlying cause is termed
secondary. Explanation: Secondary hypertension may be caused by a tumor of the adrenal gland (e.g., pheochromocytoma). Primary, or essential, hypertension has no known underlying cause. Isolated systolic hypertension is demonstrated by readings in which the systolic pressure exceeds 140 mm Hg and the diastolic measurement is normal or near normal (less than 90 mm Hg).